The effects of six months of contact lens wear on the tear film, ocular surfaces, and symptoms of presbyopes

Purpose. To assess the tear film, ocular surfaces, and symptoms of ocular d iscomfort in a presbyopic population before and after contact lens wear. Me thods. A total of 150 presbyopes (49% were previous soft contact lens weare rs) participated in a clinical trial in which they wore either monovision ( single vision Acuvue lenses) or Acuvue Bifocal contact lenses. Clinical mea surements of tear film, biomicroscopy, and corneal sensitivity as well as s ubjective ratings using the Dry Eye Questionnaire were collected at the ini tial visit and repeated after 6 months. Comparisons were made between age g roups (40 to 51 years and 52 to 71 years) and genders before and after cont act lens wear. Associations between objective and subjective tests were sou ght. Results. After 6 months of contact lens wear, clinical signs had worse ned by less than one-half of a grade, and tear break up time (TBUT) worsene d by 3 s. Only TBUT was lower for the older age group. Females had less bul bar hyperemia, more sensitive eyes, move lissamine green staining, and lowe r TBUT and phenol red thread measurements (all p < 0.04). Twenty-eight perc ent experienced dryness before contact lens wear, but this figure increased to 68% when wearing contact lenses. There were no age differences, but alm ost twice as many females as males reported dryness. Reporting symptoms of dryness was associated with gender, corneal sensitivity, and type of cornea l staining. Conclusions. These results provide a representation of the ocul ar surface condition and symptoms of ocular discomfort in the middle-aged p opulation and seem similar to reports of younger populations. Wearing conta ct lenses seems to influence dry eye symptoms more than age or gender. Ther efore, presbyopes should not be excluded from consideration for contact len s fitting.